DESCRIPTION: Agitated behavior is a widespread problem that adversely affects the health of nursing home residents and increases the cost of their care. Agitated nursing home residents are more likely to be physically or chemically restrained, to fall, and to have a lower quality of life. Current strategies to reduce agitated behavior, such as environmental modifications, tend to be costly. The overall purpose of this study is to examine a relatively inexpensive nursing intervention on the agitated behavior of cognitively impaired nursing home residents. The specific aim is to compare the effect of calming music (CM) or hand massage (HM) or a combination of CM and HM on the level and type of agitated behavior over time. This two-by-two, repeated measures design will use the Progressively Lowered Stress threshold (PLST) model (Hall & Buckwalter, 1987) to test the effect of exposure to CM or HM or a combination of CM and HM on the level of agitation in cognitively-impaired nursing home residents. The PLST model proposes that stress can be reduced and functionally adaptive behavior achieved by modifying environmental demands. Agitated subjects will be randomly assigned to one of four intervention groups: 1) CM, 2) HM, 3) CM and HM simultaneously, or 4) control. Level of agitation will be assessed during a ten minute observation period immediately before, during, immediately after, and 60 minutes after the intervention to determine whether the effect of the intervention is sustained. An anticipated outcome of this study is to learn more about improving the quality of life for nursing home residents and potentially decrease the cost of their care. RESEARCH PLAN